Temporal and spatial changes in cerebral blood flow in neuropsychiatric systemic lupus erythematosus: a subtraction brain spect study

Author(s)

Trevisan, Ana Carolina ^{[1, 2]} ; Alexandre-Santos, Leonardo ^{[1, 2]} ; Assad, Rodrigo Luppino ^[3] ; Itikawa, Emerson Nobuyuki ^[4] ; Pitella, Felipe Arriva ^[1] ; Kato, Mery ^[1] ; Silvah, Jose Henrique ^[1] ; Santos, Antonio Carlos ^[5] ; Louzada-Junior, Paulo ^[3] ; Wichert-Ana, Lauro ^{[1, 2]}

Affiliation

^[1] Univ Sao Paulo, Nucl Med & PET CT Lab, Ribeirao Preto Med Sch, Post Grad Program Internal Med, Ribeirao Preto - Brazil

^[2] Univ Sao Paulo, Sao Carlos Sch Engn USP, Interunits Bioengn Postgrad Program, Sao Carlos, SP - Brazil

^[3] Univ Sao Paulo, Ribeirao Preto Med Sch, Div Rheumatol, Dept Internal Med, Ribeirao Preto - Brazil

^[4] Univ Fed Goias, Phys Inst, Goiania, Go - Brazil

^[5] Univ Sao Paulo, Magnet Resonance Lab, Dept Med Imaging Hematol & Clin Oncol, Ribeirao Preto Med Sch, Ribeirao Preto - Brazil

• Document type: Journal article
• Source: EUROPEAN JOURNAL OF HYBRID IMAGING; v. 5, n. 1 NOV 4 2021.
• Web of Science Citations: 0

Abstract

This study was addressed to evaluate the temporal and spatial changes in regional cerebral blood flow (rCBF) of patients with neuropsychiatric systemic lupus erythematosus (NPSLE). Our objective was to correlate the subtracted SPECT coregistered to MRI features (SISCOM) with demographic, clinical and laboratory findings to shed light upon the pathophysiological evolution of the NPSLE. Twenty-six NPSLE patients with MRI and pre- and post-treatment brain SPECT with {[}99mTc]Tc-ECD. SISCOM features were categorized as improvement, worsening, activation and/or deactivation of rCBF findings. Patients mean age of 43.19 years and 65.38% white were evaluated. The patients mean age at onset of SLE was 26.05 and 42.29 for NPSLE. The mean time between the onset of SLE and first NPSLE symptoms was 05.57 years. The disease has already been initiated as NPSLE in 4 patients. The SLEDAI average score was 31.69 and the SLICC/ACR-DI score was 06.96. The patients underwent an average of 09.23 cyclophosphamide. The SISCOM findings showed functional and pathological states on different brain regions. The rCBF changes were not associated with index scores. There was, however, a trend towards an association between lower SLEDAI scores with improvement and higher SLEDAI with worsening in SISCOM, Also a trend of association between lower SLICC score with improvement, and higher SLICC with worsening. The female gender was predictive of activation and worsening, separately, and deactivation and worsening in a set. Non-white patients were predictive of worsening. The seizure was predictive of deactivation separately, and deactivation and worsening in a set. Finally, normal C3 was a predictor of improvement. The present study showed dynamic brain changes in NPSLE patients. SISCOM technique showed improved rCBF in some brain areas, and worsening, activation and deactivation in others. There were associations between rCBF changes and gender, skin colour and complement C3 and association trends with SLEDAI and SLICC scores. (AU)

• FAPESP's process: 13/25987-2 - Evaluation of the density of presynaptic dopamine Tranporters in humans: development and evaluation of quantitation protocols based on the hybrid SPECT-CT technology using 99mTc-TRODAT-1
• Grantee: Lauro Wichert Ana
• Support Opportunities: Regular Research Grants
• FAPESP's process: 15/50089-3 - Correlation with different clinical stages in patients with Parkinson's disease and neuropathic pain: validation of the Rotterdam Elderly Pain Observation Scale (REPOS)
• Grantee: Lauro Wichert Ana
• Support Opportunities: Regular Research Grants